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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The passive left ventricular pressure-volume relationship characterises left ventricular distensibility. However, it has recently been shown that acute pharmacological intervention can significantly change the position of the diastolic pressure-volume curve. We studied the effects of acute volumic expansion on the passive left ventricular pressure-volume relationship. In fact, the interpretation of left ventricular function curves during acute volumic expansion assumes that the left ventricular pressure-volume relationship remains unchanged. We measured the heart rate, cardiac output, left and right ventricular pressures with micromanometers, ventricular volumes by cineangiography 50 frames/sec (n = 6) or ventricular diameters by M mode echocardiography (n = 6) in 12 patients without valvular or coronary heart disease during rapid volumic expansion, and calculated stroke volumes and indices of left ventricular performance; the passive left ventricular pressure-volume or pressure-diameter relationship was adjusted to an exponential function P = a.ekp.V or P = a'.ek'p.De. After volumic expansion the cardiac output rose due to an increase in heart rate and stroke volume. The increase in stroke volume was related to that of end diastolic volume, the end systolic volume remaining unchanged: there was little difference in the indices of left ventricular performance. The pressure-volume and pressure-diameter curves were considerably shifted upwards and to the left during acute volumic expansion: this seemed to be due mainly to an increased intrapericardial pressure secondary to the increase in intrapericardial content. The relationship obtained by subtracting the simultaneous right ventricular from the instantaneous left ventricular pressure after volumic expansion was identical to the basal left ventricular pressure-volume curve. These observations demonstrate the importance of external factors of left ventricular compression in the changes in the passive left ventricular diastolic relationship during acute volumic expansion and invalidate the use of function curves obtained under these conditions for the assessment of left ventricular systolic function. The end diastolic pressure cannot be considered to reflect end diastolic volume and the function curves, in fact, illustrate changes in diastolic distensibility.
Arch Mal Coeur Vaiss 1983 Jul
PMID:[Changes in passive left ventricular pressure-volume relations in acute volume expansion]. 641 45

This paper describes a case of Candida Parapsilosis endocarditis in a patient with a mitral valve prosthesis implanted two years previously. This history started with a cerebrovascular accident associated with pyrexia. A complex medico-surgical therapeutic approach controlled the infection. This consisted of systemic and local (immersion of the prosthesis) antifungal therapy, bathing the left heart chambers in 5 p. 100 iodine solution and two valve replacements at 8 months intervals. The second surgery was not related to recurrence of the candida infection but to a perivalvular leak attributed to the insertion of the prosthesis into tissues inflamed by recent infection. Despite the improvement in the prognosis of fungal infection due to an early surgical approach, it is still essential to try and prevent the disease, the mortality rate still being over 80 p. 100. It is essential to be very careful when using intravenous catheters and aerosols; the indications of antibiotherapy must also be respected.
Arch Mal Coeur Vaiss 1983 Oct
PMID:[Endocarditis caused by Candida parapsilosis (para-krusei)]. 641 1

Continuous 24 hour electrocardiography (Holter monitoring) was performed in 226 patients aged 20 to 85 years (mean 61 years) presenting with focal signs of a cerebrovascular accident (CVA). The technique was the same in all patients; the study was limited to paroxysmal atrial arrhythmias. Eighty four of the 226 patients examined had atrial arrhythmias which were already known in 39 patients before Holter monitoring. In the other 187 cases, the following results were obtained: 1) 9 patients (4,8%) had paroxysmal atrial fibrillation (AF), 2) 6 patients (3,2%) had paroxysmal atrial tachycardia (PAT), 3) 11 patients (5,9%) had runs of atrial extrasystoles, 4) 19 patients (10%) had isolated atrial extrasystoles (IAE). When patients with underlying cardiac disease constituting a diagnostic indicator for arrhythmia were excluded, the following incidences were obtained: AF = 3,7%, PAT = 2,7% and runs of atrial extrasystoles = 4,3%. The majority of these arrhythmias occurred in elderly patients in whom atrial arrhythmias are known to occur and may be asymptomatic. There were practical consequences of these results, i.e. antiarrhythmic and anticoagulant therapy in 12 patients (6,4%) alone. As Holter monitoring is also associated with a number of false negative results with respect to paroxysmal atrial tachycardia, we do not believe that this investigation should be offered routinely to patients with CVA in the absence of other clinical or electrocardiographic indications.
Arch Mal Coeur Vaiss 1984 Jan
PMID:[Value of long-term electrocardiography in patients with cerebral ischemic accidents]. 642 84

This study was undertaken to determine the changes of left ventricular function during normal pregnancy. Fifteen women aged 23 to 36 years old were studied by M mode and 2D echocardiography at 3, 6 and 9 months and during the post partum period (30 days). The M mode recordings were analysed on an ID.01 computer. The principal parameters rose significantly from the 3rd to the 9th month, and then fell during the post partum period: heart rate, 73 +/- 5 to 80 +/- 9 and then to 70 +/- 8 beats/min: LV end diastolic parameter 46 +/- 2 to 49 +/- 3 mm: LV end diastolic volume 102 +/- 16 to 120 +/- 30 and then 102 +/- 22 cm3; stroke volume: 72 +/- 15 to 87 +/- 25 and then to 70 +/- 16 ml; cardiac output: 5.6 +/- 1.2 to 7.1 +/- 2.3 and then to 5.0 +/- 1.4 l/min; cardiac index: 3.5 +/- 0.7 to 4.1 +/- 1.3 and then to 3.0 +/- 0.8 l/min/m2; LV mass: 69 +/- 14 to 91 +/- 39 and then to 82 +/- 27 g; the ratio of mass/volume also increased from 0.97 +/- 0.14 to 1.10 +/- 0.5. On the other hand, the following parameters did not change significantly: LV end systolic diameter: 30 +/- 3 to 31 +/- 3 and then to 30 +/- 4 mm; ejection fraction: 0.70 +/- 0.72 and then to 0.68; LV fractional shortening: 34 +/- 5 to 36 +/- 5 and then 33 +/- 6; velocity of circumferential fibre shortening: 1.2 +/- 0.2 to 1.2 +/- 0.1 and then 1.1 +/- 0.2 circ/s.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1984 Feb
PMID:[Electrocardiographic study of left ventricular performance in normal pregnancy]. 642 5

Interatrial septal aneurysm is a rare abnormality and can now be diagnosed by echocardiography. We report the case of a 52 year old woman in whom this condition was diagnosed after an embolic cerebrovascular accident. M mode recordings showed a linear echo in the left atrial cavity in early and mid systole. The aneurysm was directly visualised by 2D echo as a hemispherical bulge in the mid portion of the interatrial septum, which was mobile and had a to-and-fro motion between the two atria in relation to the different phases of the cardiac cycle. The diagnosis was confirmed by angiography, and at surgery. A feature of this case was the close correlation between echocardiographic, angiographic and operative findings. The pathogenesis of this type of aneurysm remains conjectural as does its role in the production of cerebral embolism, the evidence for which was circumstantial in the absence of other demonstrable causes and in the light of previously reported cases.
Arch Mal Coeur Vaiss 1984 Mar
PMID:[Interatrial septal aneurysm. Echocardiographic diagnosis]. 642 20

Potassium supplementation of the diet attenuates the rise in blood pressure in stroke prone spontaneously hypertensive rats (SHRSP) without a concomitant contraction of intravascular volume. This finding favours a resistance-mediated, but not a volume-mediated hypotensive action of potassium. A possible site of effect is modulation of sympathetically mediated vasoconstriction by potassium. Sympathetic vascular tone, which is enhanced in SHRSP on a high sodium diet because of a reduced noradrenaline inactivation, a facilitated noradrenaline release and an increased sensitivity of vascular smooth muscle to noradrenaline, tends to normalize when the potassium content of the diet is augmented. All three parameters of sympathetically mediated vasoconstriction are altered by potassium in a way to attenuate the enhanced sympathetic vasoconstriction.
Arch Mal Coeur Vaiss 1984 Apr
PMID:[Possible mechanisms of action of potassium in arterial hypertension]. 642 65

The index of valvular regurgitation was measured by two techniques after technetium 99 m gamma-cineangiography: the classical technique of comparing left and right ventricular stroke volumes, and the same technique after subtracting the radioactivity arising from the right atrium from the zone of right atrioventricular superposition. The index of valvular regurgitation was calculated in 41 patients with chronic coronary artery disease without valvular regurgitation and also undergoing coronary angiography with 30 degrees right anterior oblique ventriculography, in 8 healthy volunteer subjects, at rest and on exercise; and in 15 patients with chronic aortic regurgitation also undergoing cardiac catheterization and 30 degrees right anterior oblique left ventriculography and aortography. The regurgitant index by the classical technique was 1,25 +/- 0,18; when the index was calculated again after subtracting right atrial radioactivity, a value of 1,05 +/- 0,12 (p less than 0,01) was obtained. The regurgitant index is not affected by left ventricular contractility or by the degree of left ventricular dilatation. On the other hand, this index is affected by the degree of right ventricular dilatation. The valvular regurgitant index did not vary significantly on exercise (1,01 +/- 0,11 to 1,17 +/- 0,16 NS). The isotopic regurgitant fraction deduced from the valvular regurgitant index correlated well with the angiographic regurgitant fraction (R = 0,74; p less than 0,001). The index of valvular regurgitation gives an exact, reliable and reproducible quantification of left sided regurgitant lesions. It is only valid when there is no intracardiac shunt or regurgitant right heart lesion.
Arch Mal Coeur Vaiss 1984 Aug
PMID:[Method of isotopic determination of aortic valve regurgitation]. 643 69

A 13 years study of 22 patients with surgical treatment of acute occlusion of the internal carotid artery is reported. Mortality rate was 22% (5 patients). 35% had a complete recovery of the stroke without any sequelae. 6 were better after intervention, 3 worsened. Long term mortality is 10 patients with 2 strokes and 4 myocardial infarction. No significant difference can be observed on life table of the survivors with reference to recent medical series, 60% at five years, 36% at ten years, 28% 13 at years. A review of 30 studies of the literature (1,046 cases of acute stroke or transient ischemic attacks) shows a 17% global mortality, with 50% of good results. Mortality of surgical treatment of acute carotid occlusion is lower in recent papers (inferior 10%). This progression seems to be related to the selection of the indications of surgery in stroke (shorter delay, early diagnosis with non-invasive procedures, post-operative management). The conclusion is that a surgical therapy of acute thrombosis of the internal carotid artery cannot be systemically rejected.
J Mal Vasc 1983
PMID:[Was it necessary to treat acute carotid thromboses surgically? 1962-1973: long-term results]. 666 2

112 patients (average age 66 +/- 13 years) with sinus node dysfunction, selected on clinical, electrocardiographic and electrophysiological criteria, were followed up for a period of 3 to 55 months (average: 30,2 months). Permanent cardiac pacing was instituted in 59 patients (52,6 p. 100), and the remaining patients treated medically. 25 patients were lost to follow up (22,3 p. 100: 5 paced, 20 non paced). 16 patients died (14,2 p. 100): mortality was relatively early (average 11,7 months) and higher in patients with pacemakers (15/16); the causes of death were acute heart failure (8 cases), and cerebral vascular accident (3 cases). In the surviving paced patients neurological symptoms completely regressed. In this series, the life expectancy of patients with sinus node dysfunction seemed to depend mainly on the state of their myocardium, but the functional prognosis was clearly improved by cardiac pacing.
Arch Mal Coeur Vaiss 1980
PMID:[Sinus node dysfunction. Clinical outcome and results of cardiac pacing]. 677 41

The parameter derived from right anterior oblique angiocardiography (end diastolic and end systolic volumes, stroke volume, ejection fraction, wall thickness and myocardial mass) are used to decide the most appropriate management of cardiac disease. It is important to assess their reliability especially as other clinical data may be underestimated and the objective results may play a prominent role in the decision. Therefore, good quality cinefilms of 31 patients were reinterpreted by three observers (A, B and C); the contours were traced on a Vanguard console with an electromagnetic pet and the data treated automatically by the SNIASS SYSCOMORAN program (Simpson's method, assimilating the left ventricle to an ellipsoid divided into n identical cylinders). The interobserver variability (A and B; A and C; B and C) was good in the assessment of end diastolic volume (R = 0,96; 0,98; 0,99), end systolic volume (R = 0,96; 0,96; 0,98). On the other hand, it was poor in the measurement of wall thickness (R = 0,63; 0,73; 0,69) and myocardial mass (R = 0,85; 0,83; 0,89). In addition, the ejection fraction and end systolic volume were perfectly reproducible from one observer to another whether or not the left ventricle was dilated. End diastolic volumes seemed to be more reproducible in dilated cavities (EDV greater than 104 ml/m2). These results confirm that monoplane RAO cineangiography remains a good method of assessing left ventricular performance.
Arch Mal Coeur Vaiss 1982 May
PMID:[Analysis of interobserver variations in the estimation of myocardial volume, thickness and mass in right anterior oblique monoplanar angiocardiography]. 681 Jul 84


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